Healthcare FWA Investigator - Fraud & Compliance
Centene Corporation
Centene Corporation seeks a Fraud, Waste and Abuse Investigator to conduct investigations using referrals, claims data, medical records, interviews, and analytics to identify misconduct and support case resolution. You will document findings, prepare investigative reports, referrals, and supporting documentation, and collaborate with compliance, legal, provider and payment integrity teams to ensure regulatory and policy compliance. #J-18808-Ljbffr Centene Corporation
- Centene Corporation is seeking a Fraud, Waste, and Abuse Investigator in the United States to conduct investigations... .... The role requires 2+ years in healthcare investigations and a Bachelor's... ...prepare reports, collaborate with compliance and legal teams, and ensure...Fraud
- ...Conduct field-based investigations related to Medicaid fraud, abuse, or non-compliance, aligned with UPIC protocols and state-specific Medicaid rules. Interview healthcare providers, beneficiaries, and witnesses to gather key case evidence. Analyze Medicaid claims, billing...FraudWork at office
$85k - $105k
...Healthcare Fraud Investigator Employment Type: Full-Time, Mid-Level CGS is seeking a Healthcare Fraud Investigator to provide legal support... ...: Relevant healthcare fraud experience including compliance, auditing duties, and other duties in Section 3. Relevant...FraudFull timeWork experience placementWork at officeLocal area- ...Corporation, a national leader in diversified healthcare, seeks a seasoned investigator to guide team members, investigate fraud, waste and abuse, and mentor staff. This... ...the continental United States and emphasizes compliance with CMS guidelines, federal and state laws,...FraudRemote job
$56.2k - $101k
...Position Purpose Conduct fraud, waste, and abuse (FWA) investigations by reviewing referrals, claims data, medical... ...integrity efforts while ensuring compliance with applicable laws, regulations... ...trends that may present risks to healthcare programs and recommend...FraudFull timePart timeH1bWork at officeRemote workFlexible hours$60.2k - $107.4k
A leading health care organization is looking for a Senior Investigator Pharmacy to tackle healthcare fraud, waste, and abuse. The role includes investigating complex cases and preparing detailed reports based on findings. Candidates must have a Bachelor's or Associate...Fraud$75.35k - $98.89k
...Senior Analyst, Special Investigations Unit Clinical... ...protect the integrity of healthcare spend. You will perform... ...and promote long-term compliance. You will partner with... ...audits into suspected FWA with high autonomy Document... ...(CPMA), Certified Fraud Examiner (CFE), Accredited...FraudFull timeWork at officeRemote workWork from homeFlexible hours3 days per week- ...senior leader to direct SIU analytics, detection, and investigative analytics across healthcare programs. You will work with SIU leadership and enterprise... .... The role requires 5+ years in healthcare analytics, fraud detection, SIU operations, and leadership of analytics...Fraud
- A leading health organization seeks an investigator for healthcare fraud allegations. Responsibilities include conducting investigations, analyzing claims data, and preparing reports. A bachelor's degree and 1+ years in medical claim analysis are essential. Preferred candidates...FraudRemote work
- Allied Universal® Compliance and Investigation Services is seeking an experienced SIU Investigator in New York with construction investigation experience... ...under NY Labor Law. The role focuses on identifying fraud in insurance claims and deciding on reporting to state...Fraud
- Ramp is seeking an AML Investigator to join the Compliance team in a fast-paced fintech environment. You will conduct investigations, draft SARs/UARs,... ...You will collaborate with Compliance, Risk, Product, and Fraud Operations to ensure robust financial crimes controls. The...FraudShift work
- Convera is seeking an experienced Senior Compliance Analyst to join the Compliance and Risk Investigations and Analysis team. You will independently handle complex... ...and work to identify and mitigate AML, CTF, and fraud risks. The role includes conducting Level 2 transaction...Fraud
- ...Staff Analyst to join the CFWB Policy and Compliance unit. The role supports risk, integrity... ..., focusing on child care assistance, fraud detection, and safeguarding funds.... ...for Risk and Integrity, duties include investigations of providers, reviewing cases, training...Fraud
- ...States Digital Space LLC is seeking a Compliance Operations Specialist 1 to monitor voice... ...ensuring policy compliance and reducing fraud. This remote role is based in Colombia,... ...with teams to resolve issues, using investigative skills and clear communication to support...FraudRemote jobWorldwide
- ...A healthcare company in New York is seeking a Fraud Investigator to conduct in-depth investigations of reported fraud. Responsibilities include mentoring other investigators, investigating Medicaid fraud cases, and maintaining relationships with law enforcement. Candidates...Fraud
- United States Digital Space LLC is seeking a Compliance Operations Specialist to monitor traffic, ensure CTIA-aligned policies, and prevent fraud and abuse on the platform. You will investigate cases, perform due diligence on new customers, and respond to carrier notifications...FraudRemote jobWorldwide
- ...to join a fast-paced eCommerce risk and fraud operations team. This position supports... ...language skills will be heavily utilized to investigate cases, communicate with international... ...business practices. Demonstrate and promote compliance with company policies, procedures, and...FraudContract workFreelanceRemote work
- Jobtailor is seeking an experienced Medicaid investigator to conduct field investigations and gather critical evidence across health care programs. You will interview providers and beneficiaries, analyze claims, and prepare reports for enforcement actions, with collaboration...Fraud
- CGS is seeking a Healthcare Fraud Investigator to provide Legal Support for a large Government Project in Nashville, TN. The candidate must take the initiative to ask questions to successfully complete tasks, perform detailed work consistently, accurately, and under pressure...Fraud
$32 - $40 per hour
...Advance Your Career in Insurance Claims with Allied Universal® Compliance and Investigation Services. Allied Universal® Compliance and Investigation... ...knowledge of Insurance policies and the components of fraud to determine If claims warrant reporting to the appropriate...FraudWork at officeLocal area- A government services contractor is seeking a Healthcare Fraud Investigator to provide legal support on a large Government project. You will analyze data, review financial and legal documents, and support the development of case referrals. Candidates should have a relevant...FraudFull timeFor contractorsWork at office
$26 - $30 per hour
Overview Investigator - Network Services Manhattan, NY area Immediate need for an undercover... ..., and receipts, ensuring accuracy and compliance. Must have flexibility to work varied/irregular... ..., Claims Investigation, Counter-Fraud Programs, Desktop Investigations, Social...FraudHourly payFull timeH1bH2bLocal areaImmediate startWorldwideFlexible hoursNight shift- ...yourself and help transform the future of healthcare , you’ll find your purpose here.... ...global Employment Legal team, the Sr. Investigations and Employment Advisory Specialist will... ...’s commitment to legal and regulatory compliance in handling investigations of workplace...Local areaWorldwideFlexible hours3 days per week
- First Bank & Trust is seeking a FRAML professional to monitor and investigate fraud and BSA/AML issues. You will interact with law enforcement as needed and support training sessions while ensuring compliance with regulatory requirements. You will manage alarms, alerts,...Fraud
- ...Betterment is seeking a Senior Fraud Analyst in New York City to own customer risk rating, KYC, and fraud monitoring models, partnering with Data, Compliance and Product to shape controls and monitoring. You will design rules, advise leadership on model performance, and...FraudWork at office
$95k - $120k
About the role AIG is seeking a Fraud Investigations Manager who is fluent in English and Spanish (reading, writing, and speaking) to join... ...Office. GIG is a specialized unit within AIG’s Global Legal, Compliance and Regulatory Department. AIG’s Global Legal, Compliance,...FraudFull time- Pride Health is seeking an experienced EEO Investigator to conduct internal investigations... ...prepare clear recommendations to ensure compliance with federal, state, and local laws. Responsibilities... ...evaluating findings, and traveling to healthcare facilities around New York City as...Work at officeLocal area
$100k - $135k
...teammates. ABOUT THE ROLE: We are seeking a Fraud Analyst to join our BSA/AML team. In... ...role, you will support the detection, investigation, and mitigation of financial crime... ...regulations, OFAC sanctions, and related compliance frameworks. Experience using transaction...FraudPermanent employmentTemporary work- ...Job Overview We’re hiring a Fraud Prevention Analyst to identify, analyze, and prevent... ...transactions. You’ll monitor high‑risk patterns, investigate suspicious behavior, and help strengthen... ...rules and workflows. Collaborate with compliance, risk, and customer service teams....Fraud
$69.88k - $80.36k
IMPORTANT NOTE: CANDIDATES MUST BE PERMANENT IN THE ASSOCIATE FRAUD INVESTIGATOR CIVIL SERVICE TITLE OR ARE PERMANENT IN A COMPARABLE CIVIL... ...and transparently to instill public confidence and encourage compliance while providing exceptional customer service. DOF’s Sheriff’...FraudPermanent employmentFull timeWork at officeLocal areaRemote work2 days per week
Do you want to receive more vacancies?
Subscribe and receive similar vacancies to Healthcare FWA Investigator - Fraud & Compliance. Be the first to apply!
- defense investigator New York, NY
- workplace investigator New York, NY
- corporate security investigator New York, NY
- work from home background investigator New York, NY
- ethics investigator New York, NY
- human rights investigator New York, NY
- healthcare investigator New York, NY
- security investigator New York, NY
- employee relations investigator New York, NY
- lead investigator New York, NY


